宫腔镜手术治疗肥胖患者子宫黏膜下肌瘤66例临床分析

目的:评价宫腔镜治疗肥胖患者子宫黏膜下肌瘤的疗效及其安全性。方法:经宫颈子宫肌瘤切除术或同时行经宫颈子宫内膜切除术者66例,黏膜下子宫肌瘤中0型32例,Ⅰ型26例,Ⅱ型8例。根据术后月经改善情况、剩余肌瘤有无增长、是否再次手术等将疗效分为满意和不满意。结果:应用宫腔镜手术治疗黏膜下子宫肌瘤,术后满意率为97%,0型、I型术后满意率达100%。Ⅱ型子宫肌瘤中切除范围≥70%者2例,术后随访残余肌瘤不再增长。全部手术无1例发生并发症。结论:宫腔镜是治疗肥胖患者黏膜下肌瘤的最佳方法。掌握肥胖患者的生理特点、充分做好围手术期评估、术前准备完善,可降低此类患者的宫腔镜手术及麻醉风险。

Clinical analysis of 66 cases fat patients uterine submucous myoma treatment in hysteroscope

Objective:To evaluate the curative effect and the safe of treating uterine submucous myoma of fat patients with hysteroscope.Methods:66 cases were treated by hysteromyoma excision or endometrectomy simultaneously through cervix uteri.There were 32 0 type submucous myoma and 26Ⅰtype submucous myoma and 8 Ⅱ type submucous myoma in study.The curative effect was evaluated as satisfaction or no-satisfaction according to post-operation menstruation amendment,remaining muscular tumor grow condition,repeated operation condition.Results:The post-operation satisfaction rate of treating submucous myoma through hysteroscope operation was 97%.The post-operation satisfaction rate of 0 and Ⅰ type of was 100%.There were 2 cases whose resection range of Ⅱ type submucous myoma was ≥70%.Remain muscular tumor had not growled in post-operation follow up.there were on complication in all operation.Conclusion:The hysteroscope operation is safe and dependable.It is best choice in treating submucous myoma.Grasping physiological feature of fat patients,thoroughly evaluating peri-operation stage,consummating ante-operative preparation can degrade hysteroscope operation and anesthesia risk.